Types of Mental Health Practitioners

What do you do when signs and symptoms that aren't physically manifested in your body still affect you mentally and emotionally throughout the day? Have you ever wondered what type of doctor or mental health specialist should you seek for help?

Knowing what types of mental health professionals are available and the training they receive will help you to find the care that is most appropriate for you.

If you are suffering from a mental illness or a mental disorder, or just not feeling like yourself, a diagnostic evaluation is the first step to getting appropriate treatment. A good diagnostic evaluation will include a complete physical examination by a family physician or internist.

A diagnostic evaluation will also include a complete history of symptoms, i.e., when they started, how long they have lasted, how severe they are, whether they have occurred before and, if so, whether the symptoms were treated and what treatment was given. The mental health provider should also ask you about alcohol and drug use, and if you have had thoughts about death or suicide.

Further, a history should include questions about whether other family members have had a mental illness and, if treated, what treatments they may have received and which were effective. Last, a diagnostic evaluation should include a mental status examination to determine if speech or thought patterns or memory have been affected.

Many professionals in the field of mental health agree that a psychiatrist is best qualified to conduct a diagnostic evaluation. Unlike other mental health providers, a psychiatrist is a physician fully trained in general medicine. The breadth and depth of training is much more extensive for psychiatrists, than for all other mental health providers.

All psychiatrists are trained as general physicians first (Doctor of Medicine — M.D.), followed by a residency and internship in a hospital or clinical setting. They can become certified with the American Board of Psychiatry and Neurology after eight to ten years of training.

Since psychiatrists are trained as medical doctors they are the only mental health providers who can prescribe medication. Psychologists, social workers and other mental health counselors cannot. Psychiatrists are mental health professionals trained to work with a biopsychosocial model.

They are trained to know the biological components of disease, the "psychological components" such as emotional interactions, behaviors, cognitions, and the "social components" such as environmental factors (i.e., work, home, interpersonal relationships).

Psychiatrists often work in hospital settings (though many practice privately) and are called upon to treat severe mental illnesses such as schizophrenia, manic-depression, and paranoia.

Psychologists

Unlike psychiatrists, who have extensive training in the biological components of mental disease, psychologists are trained more in the psychological and/or behavioral components of mental illness. Psychologists receive their degrees, either Doctor of Philosophy — Ph.D. or Doctor of Psychology — Psy.D., from one of 750 accredited colleges or universities.

All psychologists must first complete four years in a Bachelor of Arts or Science program before enrolling in a Ph.D. or Psy.D. program. They are required to fulfill a minimum of 3 full-time academic years of study and a one-year, practical internship in an in-patient or out-patient setting. This one year is also known as a "post-doctorate".

The Ph.D. in psychology may be in "clinical" psychology (with a focus on research and practice), or "counseling" psychology (with a focus on practice in less pathological populations). The Psy.D. degree places emphasis on practice rather than research, and the program emphasizes training psychologists who work with patients, as opposed to research groups.

Psychologists today often focus on cognitive-behavioral therapies (talk), and do not have as intense a training regimen in the biological components of mental health disease as psychiatrists.

Many become researchers with emphasis on statistical analysis. During their training programs psychologists are taught about human development, individual differences in behavior, dysfunctional behavior, and professional standards and ethics.

Psychologists work in a variety settings including hospitals, clinics, private practice, schools and universities. Many patients with problems such as eating disorders, mild depression, alcohol or drug addiction are often referred to psychologists for therapy sessions, but also see psychiatrists for their drug treatments.

Licensed Social Workers

The last category of mental health providers are licensed social workers (L.S.W.) Licensed social workers are also considered mental health providers because many deal with the issues surrounding life events, substance abuse, family conflicts, disabilities, and violence. However, unlike psychiatrists and psychologists, social workers also address problems such as inadequate housing, health and work problems.

According to the National Association of Social Workers, "Social workers are trained professionals who have bachelor's, master's or doctoral degrees in social work. They practice in a wide variety of settings, including family services agencies, community mental health centers, child welfare, private practice, schools, hospitals, businesses, nursing homes, courts, prisons and public and private agencies."

Licensed social workers fill a niche in mental health counseling by not only offering therapy to help those with mental illness, but also aiding patients with community care. The wide range of agencies with which social workers work make them one of the best mental health providers who fully understands and utilizes the community resources available.

Thus, there are many different types of mental health professionals available to deal with a wide variety of mental disorders and. From mild to debilitating, social workers, psychologists and psychiatrists are all trained to deal with different components of the mental health spectrum.

Degrees Explained

Doctoral Degrees

M.D.—Medical Doctor: Degree awarded psychiatrists and other doctors such as internists, cardiologists, etc.

D.O.—Doctor of Osteopathy: Degree with same residency training as M.D., but emphasis on natural and alternative therapies.

Ph.D.—Doctor of Philosophy: Degree awarded psychologists. Also a traditional academic doctorate which enables the degree holder to teach at a college or university. Ph.D.'s are also awarded in social work and nursing.

Psy.D.—Doctor of Psychology: Degree awarded to psychologists. Emphasis on practice rather than research.

D.S.W.—Doctor of Social Work: Degree awarded social workers. Advanced degree held by educators in social work.

Ed.D.—Doctor of Education: Degree conferred by Schools of Education with emphasis on teaching in the respective field.

D.Sc.—Doctor of Science: Degree similar to the Ph.D. but more emphasis on practical, real-world experience rather than research. More common in Canada than the U.S. and in public health programs.

Master's Degrees

M.S.W.—Master of Social Work: Traditional degree for social workers, same level as Licensed Clinical Social Worker.

L.C.S.W.—Licensed Clinical Social Worker: Social worker who has been licensed by the state to practice counseling.

M.Ed.—Master of Education: Degree awarded by Schools of Education.

M.S. or M.A.—Masters of Science or Master of Arts: Traditional master's degree given by colleges and universities in the United States. A master's degree in psychology in the United States is not considered a terminal degree.

Ed.S.—Educational Specialist: This degree involves more training than a Master's degree but less than a doctorate. Counselors and school psychologists often have this degree.

M.Div.—Master of Divinity: Degree conferred to ministers or pastoral counselors.

Certifications

There are many certifications available in the mental health field, with emphasis on different mental disorders such as alcoholism, substance abuse, etc. Certifications are often provided through professional organizations and the required training, testing and examinations vary considerably. The most common certifications are:

C.S.A.C.: Certified Substance Abuse Counselor

C.A.C.: Certified Alcoholism Counselor

L.P.C.: Licensed Professional Counselor

M.F.C.C.: Marriage, Family and Child Counselor

C.C.M.H.C.: Certified Clinical Mental Health Counselor

N.C.S.C.: National Certified School Counselor

N.C.G.C.: National Certified Gerontology Counselor

Dr. Grace Tsai received her doctorate from the Johns Hopkins School of Public Health with an emphasis on Social and Behavioral Sciences. She investigated mental health issues in Asian and Asian American communities for her doctoral dissertation. She has served as a Psychiatric Epidemiologist in the Department of Mental Hygiene at Johns Hopkins. Dr. Tsai has also researched other mental health topics such as depression and suicide. She writes on mental health issues for various health organizations.